Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $67.27 / $67.27 / $304.00	Facility		$67.27	$67.27	$304.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $69.29	Professional		$67.27	$67.27	$69.29
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $78.03 / $139.30	Professional		$67.27	$78.03	$139.30
CareSource Facility/Professional Facility Modifier Low / Median / High Price $67.27 / $67.27 / $114.36	Facility		$67.27	$67.27	$114.36
CareSource Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $90.81	Professional		$67.27	$67.27	$90.81
Cigna Facility/Professional Facility Modifier Low / Median / High Price $63.47 / $63.47 / $67.27	Facility		$63.47	$63.47	$67.27
Cigna Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $95.20	Professional		$67.27	$67.27	$95.20
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $176.32 / $176.32 / $176.32	Facility		$176.32	$176.32	$176.32
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $109.36	Professional		$67.27	$67.27	$109.36
Molina Facility/Professional Professional Modifier Low / Median / High Price $69.98 / $72.95 / $73.99	Professional		$69.98	$72.95	$73.99
United Facility/Professional Professional Modifier Low / Median / High Price $67.27 / $67.27 / $85.97	Professional		$67.27	$67.27	$85.97